| Mr Bruce Evan Koch, CRNA MSN | |
|
5633 N Lidgerwood, Spokane, WA 99208 | |
| (509) 482-0111 | |
| Not Available |
| Full Name | Mr Bruce Evan Koch |
|---|---|
| Gender | Male |
| Speciality | Certified Registered Nurse Anesthetist (crna) |
| Experience | 39 Years |
| Location | 5633 N Lidgerwood, Spokane, Washington |
| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1336128180 | NPI | - | NPPES |
| RN00163452 | Other | WA | STATE LICENSE |
| RN3329700 | Medicaid | CA | |
| AP30007302 | Other | WA | STATE LICENSE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 367500000X | Nurse Anesthetist, Certified Registered | AP30007302 (Washington) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Astria Sunnyside Hospital | Sunnyside, WA | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Evergreen Anesthesia Associates Llc | 7113284530 | 26 |
| Entity Name | Evergreen Anesthesia Associates LLC |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1225575996 PECOS PAC ID: 7113284530 Enrollment ID: O20171120002054 |
| Mailing Address | Practice Location Address |
|---|---|
| Mr Bruce Evan Koch, CRNA MSN 5633 N Lidgerwood, Spokane, WA 99208 Ph: (509) 482-0111 | Mr Bruce Evan Koch, CRNA MSN 5633 N Lidgerwood, Spokane, WA 99208 Ph: (509) 482-0111 |
Chelsea Posenjak, Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 101 W 8th Ave, Spokane, WA 99204 Phone: 509-474-3131 |
Michael Duane Petty, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 101 W 8th Ave, Mother Gamelin Center 3rd Floor, Spokane, WA 99204 Phone: 509-474-2072 |
Dino Karahodzic, Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 101 W 8th Ave, Spokane, WA 99204 Phone: 509-474-3181 |
Stephanie De Reza, Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 101 W 8th Ave, Spokane, WA 99204 Phone: 000-000-0000 |
Matthew Ryan Queral, CRNA Nurse Anesthetist - CR Medicare: May Accept Medicare Assignments Practice Location: 101 W 8th Ave, Spokane, WA 99204 Phone: 509-474-3181 |
Leah Nicole Triulzi, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 800 W 5th Ave, Spokane, WA 99204 Phone: 509-473-5800 |
Amber George, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 101 W 8th Ave, Spokane, WA 99204 Phone: 509-474-3181 Fax: 509-227-7070 |